Scientific Name: Alfalfa
Other Names: Feuille de Luzerna, Lucerne, Medicago, Medicago sativa, Purple Medick

Who is this for?

Uses

Currently, the most convincing clinical evidence for a medical effect of alfalfa is for controlling cholesterol. In several animal and human studies, alfalfa supplements reduced blood cholesterol levels, particularly for individuals with a specific kind of high cholesterol known as type II hyperlipoproteinemia. Although the exact reasons are not understood completely, fibers and chemicals in alfalfa appear to stick to cholesterol, keeping it from staying in the blood or depositing in blood vessels. More of the harmful types of cholesterol leave the body, while high-density lipoprotein (HDL—the “good” kind of cholesterol—seems not to be affected.

Results of animal studies show that alfalfa may also lower blood sugar levels slightly due to its high manganese content. Manganese is a trace element that is thought to be involved with several body processes, including the use of carbohydrates from food. Some of the enzymes that control carbohydrate use and blood sugar levels depend on manganese as an activator. Low levels of manganese have been associated with diabetes in some studies. However, manganese may be toxic in high doses. For manganese, the U.S. National Academy of Sciences has set the adult tolerable upper limit (the highest amount of a substance that probably will not cause side effects for the majority of individuals taking it) at 11 mg per day. Side effects such as confusion, memory loss, stiffness, or trembling may result from taking too much manganese. Individuals who use a product containing manganese should be careful not to take more than 11 mg daily.

Theoretically (based on other laboratory and animal studies) alfalfa may also have other medical effects. It may have some ability to enhance immune system function. Chemicals in alfalfa have mild diuretic properties, which may promote the loss of water from the body. Therefore, alfalfa may relieve swelling caused by excess water accumulation. Because other components of alfalfa may act somewhat like the female hormone, estrogen, it has been suggested as potentially useful in relieving the symptoms of menopause. In some countries, alfalfa seeds are used as a folk remedy for asthma or other breathing conditions. However, no substantial proof exists to support the use of alfalfa in any of these conditions. P>

In studies, laboratory monkeys that regularly ate alfalfa seeds developed a condition resembling systemic lupus erythematosus (SLE). Case reports of lupus-like symptoms in humans who ate alfalfa seeds have also been published. In addition, consuming alfalfa seeds apparently caused symptoms of SLE to return in two individuals who suffered from SLE but whose disease was inactive. Although no corroborative clinical studies have been conducted in humans, individuals with SLE should not take alfalfa.

In other animal studies, alfalfa caused the muscles in the uterus to tighten. Potentially, this tightening could cause a miscarriage, so alfalfa products should not be taken by women who are pregnant.

Since 1995, several instances of alfalfa sprouts or seeds that were contaminated with bacteria have been documented. Eating products contaminated with bacteria could cause diarrhea, fever, stomach cramps, and vomiting. Because of this risk, consumption of alfalfa sprouts is not recommended for children, the elderly, or anyone with conditions that affect the immune system. Alfalfa seeds should also be avoided by these individuals.

Women with hormone-dependent conditions such as endometriosis, uterine fibroids, and cancers of the breast, ovaries, or uterus should not take alfalfa due to its possible hormonal effects. Men with prostate cancer should also avoid taking alfalfa.

Precautions

Taking alfalfa can make unprotected skin more sensitive to sunlight or artificial light in sun tanning parlors. Individuals who use alfalfa should be sure to use sunscreen.

What side effects should I watch for?

Major Side Effects

In a documented case, one individual who ate more than 100,000 mg (100 grams) of alfalfa seeds per day, experienced a condition known as pancytopenia. In this condition, normal production of both red blood cells and white blood cells decreases. Possible results include bleeding gums, bruising, fatigue, or less resistance to infections. When the individual stopped consuming alfalfa seeds, blood cell production gradually returned to normal.

Less Severe Side Effects

Allergic reactions to alfalfa have been reported. Alfalfa is a member of the same family of plants as peas, peanuts, and soybeans. Therefore individuals sensitive to one of those related plants may also be sensitive to alfalfa.

What interactions should I watch for?

Prescription Drugs

Because alfalfa may have a lowering effect on blood sugar, alfalfa may increase the effectiveness of medications used for the treatment of diabetes. Individuals who use insulin or take oral medications for diabetes should talk to a doctor or pharmacist before using alfalfa.

The possible diuretic (promoting the loss of water from the body) effect of alfalfa could increase the effectiveness of “water pills”. Individuals taking a diuretic drug, such as Dyazide, furosemide, or hydrochlorothiazide, should discuss the use of alfalfa with a doctor or pharmacist before beginning to use it.

Alfalfa contains large amounts of vitamin K, a substance that helps the blood to clot. When it is taken with antiplatelets or anticoagulants—drugs that prevent blood clotting, alfalfa may decrease the drug's effects and blood clots may form.

• Antiplatelets include clopidogrel and Ticlid
• Anticoagulants include heparin and warfarin

Chemicals in alfalfa may act like estrogen in the body. When it is taken at the same time as hormone replacement therapy (HRT) or oral contraceptives, alfalfa may interfere with the way the body uses the drug. As a result, HRT or oral contraceptives may not be as effective, some women may experience increased side effects, and the risk of an unintended pregnancy may be slightly higher.

Because it may possibly enhance immune system function, alfalfa may interfere with the effects of corticosteroids (such as dexamethasone, methylprednisolone, prednisolone, prednisone, and others) and drugs used to suppress the immune system after organ transplants or in other conditions. Taking alfalfa is not recommended for patients who take anti-rejection drugs such as:

• azathioprine
• CellCept
• cyclosporine
• Prograf
• Rapamune
• Zenapak

Non-prescription Drugs

Alfalfa can increase the ability of blood to clot after an injury. Aspirin delays clotting, so taking alfalfa could interfere with the anticoagulant effects of aspirin. Alfalfa should not be used while aspirin is being taken on a regular basis.

Alfalfa has been shown to block the absorption of vitamin E from the diet. Even though no serious results have been reported and the possibility is slight, it is possible that a vitamin E deficiency could occur.

Herbal Products

Theoretically, if alfalfa is used with other herbs that affect blood clotting, bleeding or clotting may occur. Some of the most common herbal products that might reduce blood clotting are:

• Danshen
• Devil's Claw
• Eleuthero
• Garlic
• Ginger (in high amounts)
• Ginkgo
• Horse Chestnut
• Panax Ginseng
• Papain
• Red Clover
• Saw Palmetto

Herbal products that might promote blood clots include nettles and plantain.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how alfalfa interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.

Should I take it?

A native of southwestern Asia and southeastern Europe, alfalfa is now grown throughout the world—primarily as a food crop for animals. In addition, alfalfa has been used as human food and herbal medicine for at least 1500 years. Alfalfa seeds are easy to sprout (allow to begin growing) by keeping them in a dark place and moistening them with cool water several times a day. In only a few days, the slightly sweet, very crunchy sprouts are ready to eat raw or add to cooked dishes. Alfalfa leaves and stems also may be eaten raw in salads or cooked as a vegetable. Although ingesting alfalfa seeds or sprouts may be associated with a small decrease in blood cell production, the leaves, sprouts, and stems provide a good source of protein as well as vitamins and minerals.

Alfalfa grows as a perennial that is usually less than 3 feet tall. A member of the pea family of plants, each alfalfa plant has several upright stems that bear clover-like leaves and reddish or purple flowers. The leaves and stems are the parts of alfalfa that are used for medicine. Cut before the plant blooms, these “aerial” (above ground) parts usually are dried for medical use as capsules, extracts, tablets, and teas. The ancient Greeks used alfalfa to treat a variety of diseases including bladder and kidney conditions. Traditional Chinese medicine still uses alfalfa to treat kidney stones.

Dosage and Administration

To lower cholesterol in adults, a typical dose of alfalfa is 40 mg of alfalfa seed or 5,000 mg to 10,000 mg (5 grams to 10 grams) of dried alfalfa leaves and stems three times a day. Dried alfalfa may be taken as capsules, tablets, or tea made from soaking dried alfalfa in boiling water for 10 minutes to 15 minutes, then straining solid particles out of the tea before drinking it.

Doses for other potential uses vary greatly. Individuals who choose to take alfalfa should follow the directions on the package that is purchased.

Summary

The best researched use of alfalfa in modern herbal medicine is for helping to control cholesterol. It may also have some usefulness in treating diabetes and improving immune system function. It may have mild diuretic and slightly estrogenic effects, but more studies are needed before these and other potential uses can be recommended.

Risks

Alfalfa may activate or re-activate SLE. Alfalfa sprouts may contain bacteria that could cause nausea and stomach upset. The seeds of alfalfa may cause miscarriage by promoting uterine muscle contraction.

Side Effects

Consuming large amounts of alfalfa seeds has been associated with pancytopenia—a condition in which the production of red blood cells and white blood cells decreases. Individuals taking alfalfa may be more prone to sunburn and alfalfa may cause allergic symptoms, especially in individuals who are sensitive to members of the pea family of plants.

Interactions

Alfalfa may interfere with diabetes medications, estrogen, water pills, and immune-suppressing drugs. The effects of drugs or herbal products that affect the blood's ability to clot may be changed by taking alfalfa.

Last Revised July 19, 2007

References

A.D.A.M., Inc. Manganese. April 2002. Available at: http://www.healthandage.com/html/res/com/ConsSupplements/Manganesecs.html. Accessed June 23, 2003.

Akaogi J, Barker T, Kuroda Y, et al. Role of non-protein amino acid L-canavanine in autoimmunity. Autoimmune Review. 2006;5(6):429-435.

Alcocer-Varela J, Iglesias A, Llorente L, Alarcon-Segovia D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis and Rheumatism. 1985;28(1):52-57.

Anon: Alfalfa. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. March 2001.

Avato P, Bucci R, Tava A, et al. Antimicrobial activity of saponins from Medicago sp.: structure-activity relationship. Phytotherapy Research. 2006;20(6):454-457.

Boue SM, Wiese TE, Nehls S, et al. Evaluation of the estrogenic effects of legume extracts containing phytoestrogens. Journal of Agricultural and Food Chemistry. 2003;51(8):2193-2199.

Breuer T, Benkel DH, Shapiro RL, Hall WN, Winnett MM, Linn MJ, et al. A multistate outbreak of Escherichia coli O157:H7 infections linked to alfalfa sprouts grown from contaminated seeds. Emerging Infectious Diseases. 2001;7(6):977-982.

Brown AC. Lupus erythematosus and nutrition: a review of the literature. Journal of Renal Nutrition. 2000;10(4):170-183.

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Institute of Food Science & Technology (UK). Phytoestrogens. 2001. Available at: http://www.ifst.org/hottop34.htm. Accessed June 23, 2003.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

Mahon BE, Ponka A, Hall WN, Komatsu K, Dietrich SE, Siitonen A, et al. An international outbreak of Salmonella infections caused by alfalfa sprouts grown from contaminated seeds. Journal of Infectious Diseases. 1997;175(4):876-882.

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Last Revised July 19, 2007

Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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